CN-121987332-A - Duodenal ablation system and method combined with three-dimensional reconstruction

CN121987332ACN 121987332 ACN121987332 ACN 121987332ACN-121987332-A

Abstract

The invention provides a duodenal ablation system and a method combining three-dimensional reconstruction. The duodenum ablation system combining with three-dimensional reconstruction comprises a main control unit, a three-dimensional reconstruction module, an intelligent ablation planning module, a nerve function mapping module, an ablation execution device and a real-time monitoring and feedback control module, wherein the nerve excitability of a target area can be functionally evaluated and mapped before ablation through an integrated intracavity electrical stimulation mapping technology, and a nerve high risk area is intuitively marked on a three-dimensional mucous membrane model. The system can actively avoid the areas during automatic path planning, or adopts verified safe energy parameters in the areas, thereby protecting important enteric nerve functions to the maximum extent and reducing the risks of related complications of nerve injury from the source. Thereby achieving the purposes of intelligent navigation, automatic planning, individual self-adaptive control and functional neuroprotection.

Inventors

WANG XIAOLONG
GONG JIE
LI JING

Assignees

北京维康达心科技有限公司

Dates

Publication Date: 20260508
Application Date: 20260326

Claims (10)

1. A duodenal ablation system incorporating three-dimensional reconstruction, comprising: The system comprises a main control unit, a three-dimensional reconstruction module, an intelligent ablation planning module, a nerve function mapping module, an ablation execution device and a real-time monitoring and feedback control module; The three-dimensional reconstruction module, the intelligent ablation planning module, the nerve function mapping module, the ablation executing device and the real-time monitoring and feedback control module are electrically connected with the main control unit; The three-dimensional reconstruction module is used for generating and updating a three-dimensional mucosa model in the duodenal cavity in real time based on the acquired data; The intelligent ablation planning module is used for automatically planning the positions and the moving paths of ablation points based on the three-dimensional mucosa model to obtain a preliminary ablation path; the nerve function mapping module comprises a nerve stimulation unit, a nerve response detection unit, a nerve map generation unit and a safety path planning optimization unit; The nerve stimulation unit is used for applying diagnostic electrical stimulation to the duodenal wall; The nerve response detection unit is used for detecting intestinal wall micro-feedback signals caused by electric stimulation; The nerve atlas generating unit is used for generating a nerve excitability thermodynamic diagram on the three-dimensional mucous membrane model based on the coordinate of each electric stimulation point and the corresponding nerve response threshold value and amplitude; The safety path planning optimizing unit is used for optimizing the preliminary ablation path planned by the intelligent ablation planning module based on the nerve excitability thermodynamic diagram; the ablation executing device is used for executing ablation operation under the guidance of the optimized path; The real-time monitoring and feedback control module is electrically connected with the ablation execution device and is used for collecting ablation parameters in real time and dynamically adjusting the ablation energy output.
2. The system of claim 1, further comprising a multi-modality image fusion and navigation module and a display and interaction unit, wherein the multi-modality image fusion and navigation module and the display and interaction unit are electrically connected to the main control unit, The multi-modal image fusion and navigation module is used for registering the three-dimensional mucous membrane model and the real-time medical image to generate an augmented reality navigation interface, The display and interaction unit is used for displaying the augmented reality navigation interface, the ablation path, the nerve excitation thermodynamic diagram and the real-time monitoring parameters.
3. The duodenal ablation system of claim 1 in combination with a three-dimensional reconstruction, wherein the three-dimensional reconstruction module comprises: The preoperative image importing unit is used for importing and reconstructing CT or MRI images and generating a priori model of the duodenal anatomy structure; the intraoperative real-time acquisition unit is integrated at the head of the catheter and comprises a structured light/laser scanning assembly, an electromagnetic or impedance positioning unit and a visual unit, and is used for acquiring intra-cavity dense point cloud data, catheter position information and endoscope video stream; And the multi-source data fusion unit is used for fusing the prior model, the point cloud data, the catheter position information and the video stream under a unified coordinate system to generate a real-time updated three-dimensional mucous membrane model.
4. The duodenal ablation system of claim 1 in combination with three-dimensional reconstruction, wherein the safe path planning optimization unit is configured to perform one or more of the following: Re-planning an ablation path to bypass a highly neural excitatory core region identified in the neural excitatory thermodynamic map; in the high nerve excitability area, automatically switching to a safe ablation mode with preset energy parameters lower than set values; And before the ablation operation of the high nerve excitability area is executed, a mandatory secondary confirmation prompt message is sent out.
5. The duodenal ablation system of claim 1, wherein the real-time monitoring and feedback control module comprises: the multi-parameter sensing unit is used for collecting at least one of contact force, tissue impedance, local temperature, image characteristics, intra-cavity pressure waveform and electrophysiological signals in real time; the self-adaptive energy control unit is used for dynamically adjusting ablation energy and time based on the data acquired by the multi-parameter sensing unit and morphological characteristics of the three-dimensional mucous membrane model; And the ablation boundary prediction unit is used for visually predicting the ablation range and depth on the three-dimensional mucous membrane model in real time based on the data and the energy parameters acquired by the multi-parameter sensing unit and combining with a pre-established energy, depth and range mapping model.
6. The duodenal ablation system of claim 1 in combination with three-dimensional reconstruction, wherein the ablation performing means comprises a smart ablation catheter and a robotic-assisted drive unit; the intelligent ablation catheter head is integrated with an ablation energy generator, a contact force sensor, a temperature sensor and an optical scanning element, wherein the ablation energy generator is at least one of a radio frequency electrode, a pulse electric field electrode, a laser unit and a thermal steam unit; The robot auxiliary driving unit is electrically connected with the intelligent ablation catheter and used for realizing automatic positioning and stable fitting of the catheter.
7. A method of duodenal ablation in combination with three-dimensional reconstruction, based on the system of any one of claims 1-6, comprising: The method comprises the steps of data acquisition and three-dimensional model construction, namely importing preoperative images, conveying an ablation catheter to a target segment of the duodenum, and generating and updating a three-dimensional mucosa model in a duodenal cavity in real time by utilizing a scanning assembly and a vision module of the head of the catheter; Registering the three-dimensional mucosa model with the medical image in the operation to generate and display an augmented reality navigation interface fused with the real-time catheter position and the preliminary planning path; A personalized ablation path planning step, namely automatically identifying a target ablation intestinal section based on the three-dimensional mucosa model, and planning a preliminary ablation point position, a preliminary ablation point sequence and a preliminary catheter movement path to obtain a preliminary ablation path; Guiding a catheter to conduct nerve function mapping on a planned ablation area, applying diagnostic electrical stimulation on mapping points, synchronously monitoring intra-cavity pressure and electrical signal changes, recording the space coordinates of each mapping point and the stimulation threshold value of positive nerve response caused by the space coordinates of each mapping point, integrating all mapping point data, generating and displaying a nerve excitability thermodynamic diagram on the three-dimensional mucous membrane model, optimizing a preliminary ablation path based on the nerve excitability thermodynamic diagram, and generating a safe ablation path; the real-time accurate ablation step under the guidance of nerve function comprises the steps of executing ablation operation along the safe ablation path under the guidance of an augmented reality navigation interface fused with a nerve excitability thermodynamic diagram, and monitoring parameters in real time and dynamically adjusting ablation energy in the process of the ablation operation; and (3) performing instantaneous evaluation and supplementary ablation in operation, namely performing secondary scanning on the target area after ablation, comparing the three-dimensional mucosa model after ablation with the three-dimensional mucosa model before ablation, automatically calculating ablation coverage rate, marking a missing area, performing safe ablation path planning on the missing area, and performing supplementary ablation.
8. The method of claim 7, wherein in the step of intraoperative immediate assessment and supplemental ablation, the intraoperative immediate assessment comprises: For an ablation mode capable of causing color/texture changes, directly comparing the color and texture changes of the three-dimensional mucosa model before and after ablation; and (3) for an ablation mode which cannot cause obvious color change, after the dye is sprayed, performing secondary scanning and three-dimensional mucosa model contrast analysis on the target area.
9. The method of claim 7, wherein in the step of functional nerve mapping and safety margin calibration, the recording of the spatial coordinates of each mapping point and the stimulation threshold thereof for triggering a positive nerve response comprises: and extracting weak intra-cavity pressure signals and electric signals induced by stimulation from background noise by wavelet analysis or phase-locked amplification technology to judge whether positive neural response is triggered.
10. The method of claim 7, wherein in the step of functional nerve mapping and safety margin calibration, the preliminary ablation path is optimized to generate a safety ablation path, comprising: And generating the safe ablation path by adopting a multi-target optimization algorithm, wherein the optimization targets comprise maximum coverage of an ablation area, minimum moving path of a catheter and maximum avoidance degree of a high nerve excitability area.

Description

Duodenal ablation system and method combined with three-dimensional reconstruction Technical Field The invention belongs to the technical field of medical treatment, and particularly relates to a duodenal ablation system and method combined with three-dimensional reconstruction. Background In recent years, in the biomedical engineering industry, duodenal mucosa thermal ablation has become an emerging and effective interventional therapy for treating type 2 diabetes. The principle is that the surface layer of the duodenal mucosa is ablated by controllable energy, so that the regeneration of the mucosa is promoted, and the insulin resistance and the blood sugar regulation and control are further improved. The prior duodenal ablation equipment and related technologies are as follows: The balloon catheter thermal ablation system adopts an expansion balloon to attach to the intestinal wall and uniformly ablates by injecting hot saline or steam, but relies on two-dimensional X-ray positioning, so that three-dimensional structure perception and individuation navigation cannot be realized. Multiple electrode radio frequency ablation systems, which perform point-by-point ablation through deployable electrode arrays and monitor tissue impedance changes, still lack real-time three-dimensional guidance and adaptive path planning capabilities. Pulsed electric field ablation (PFA) and cryoablation, although each feature, have significant shortcomings in real-time visualization, precise control and immediate assessment during surgery. The prior art mainly has the following limitations: The visual dimension is low, the three-dimensional space information is lacking depending on two-dimensional X-ray or direct vision of an endoscope, the fitting condition of an ablation head and complex mucous membrane folds is difficult to judge, and ablation omission or overlapping is easy to cause. The control strategy is stiff, namely, preset energy parameters and time are adopted, and although impedance feedback is introduced into part of the system, the real-time three-dimensional anatomical information is not combined for personalized path planning and dynamic energy adjustment. The lack of immediate assessment during operation usually depends on endoscopic review for several weeks after operation, and the failure to judge the coverage rate and uniformity of ablation in real time during operation may lead to insufficient curative effect or need of secondary operation. Operation dependent experience-selection of ablation points and path dependent operator experience, it is difficult to achieve standardization and repeatability. Furthermore, the prior art ablations present a dead zone in neuroprotection, in which the duodenal wall is rich in the complex Enteric Nervous System (ENS) and in the peripheral nerve (e.g., vagus nerve) endings, which are critical to intestinal motor, secretion and sensory function. The prior art of ablation, whether based on temperature, impedance, or preset anatomical paths, lacks the ability to identify and locate functional neural structures intraoperatively in real time. Ablation energy may accidentally damage these nerves, resulting in complications such as post-operative intestinal dysmotility, delayed gastric emptying, etc. Disclosure of Invention Aiming at the problems in the prior art, the invention provides a duodenal ablation system and a method combining three-dimensional reconstruction. In a first aspect, embodiments of the present disclosure provide a duodenal ablation system incorporating three-dimensional reconstruction, comprising: The system comprises a main control unit, a three-dimensional reconstruction module, an intelligent ablation planning module, a nerve function mapping module, an ablation execution device and a real-time monitoring and feedback control module; The three-dimensional reconstruction module, the intelligent ablation planning module, the nerve function mapping module, the ablation executing device and the real-time monitoring and feedback control module are electrically connected with the main control unit; The three-dimensional reconstruction module is used for generating and updating a three-dimensional mucosa model in the duodenal cavity in real time based on the acquired data; The intelligent ablation planning module is used for automatically planning the positions and the moving paths of ablation points based on the three-dimensional mucosa model to obtain a preliminary ablation path; the nerve function mapping module comprises a nerve stimulation unit, a nerve response detection unit, a nerve map generation unit and a safety path planning optimization unit; The nerve stimulation unit is used for applying diagnostic electrical stimulation to the duodenal wall; The nerve response detection unit is used for detecting intestinal wall micro-feedback signals caused by electric stimulation; The nerve atlas generating unit is used for generating a nerve excitability therm